{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"ROBERT  J CARTER","gend":0,"add":"8561 SPRING GARDEN ROAD","city":"BLAIRS","state":"VA","zip":"24527-9998","dob":"1975-06-17","age":"","mstatus":"","insh":"2374520*01","cliId":"","pno":4343347335,"cno":4343347335,"email":"","ename":"","eno":"","pphy":"DHIVIANATHAN, SUSAN MD","ppno":4347911562,"pcpadd":"414 PARK AVENUE","pcpcity":"DANVILLE","pcpstate":"VA","pcpzip":"24541-9998","pcpcounty":"","pcpid":"","pcpname":"","plan":"OHP","program":"MEDICAID","lob":"M4","region":"CHARLOTTESVILLE WESTERN","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":4347913776,"pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["M79.672","K22.70","K64.9","Z72.0","S91.332A","F17.200","W34.00XA","V58.89","W34.00XD","I73.9","R19.7","K64.8","R10.84","NO DATA","K29.60","L25.9","S30.861A","K52.9","J32.9","W57.XXXA","Z20.822","R20.2","B86.","L84.","K92.1","G90.522","L97.522","G90.50","G62.9","R10.13","R11.2","R23.2","G56.80","R11.0","R10.9","R19.4","Z01.89","R14.0","L53.8","L30.4","K21.9","Z71.6","E78.5","A77.0","R60.0","K58.9","F17.210","R21.","K62.89"],"date":["2022-12-23","2023-04-20","2023-02-23","2023-04-20","2021-03-31","2022-10-05","2021-03-31","2021-10-04","2021-04-28","2021-11-11","2023-04-20","2023-04-20","2022-06-21","2022-06-21","2022-06-21","2022-12-23","2022-04-17","2022-04-17","2022-04-17","2022-04-17","2022-04-17","2022-05-26","2023-03-01","2021-10-04","2023-04-20","2023-03-07","2021-03-02","2022-06-02","2022-03-04","2022-05-02","2022-05-02","2022-05-02","2022-05-02","2022-05-19","2022-05-19","2022-06-21","2022-05-19","2022-05-19","2022-10-05","2023-03-31","2022-12-23","2022-10-05","2022-12-23","2022-04-29","2022-12-23","2022-12-23","2022-12-23","2023-02-23","2023-04-20"],"priorHcc":["","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","",""]}}]},{"t":"Covid Screening","q":[{"a":[]}]},{"t":"Self-Assessment and Social History","q":[{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Activities of Daily Living","q":[{"a":[]}]},{"t":"Medical History","q":[{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Family History","q":[{"a":[]}]},{"t":"Preventive Care","q":[{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Allergies \/ Medications","q":[{"a":[]},{"a":{"comment":"","sub":[["","65862042005","SMZ\/TMP DS","TAB 800-160","20","Select","Select",""],["","65862007701","CIPROFLOXACN","TAB 500MG","20","Select","Select",""],["","00093101042","MUPIROCIN","OIN 0.02","22","Select","Select",""],["","69097094312","GABAPENTIN","CAP 300MG","90","Select","Select",""],["","68462010530","ONDANSETRON","TAB 4MG","8","Select","Select",""],["","24658031205","DOXYCYCL HYC","TAB 100MG","20","Select","Select",""],["","57237016199","OMEPRAZOLE","CAP 20MG","30","Select","Select",""],["","00378668910","PANTOPRAZOLE","TAB 40MG","90","Select","Select",""],["","62559043001","HYDROCORT","CRE 0.01","28","Select","Select",""],["","72578008801","NYSTAT\/TRIAM","OIN ","30","Select","Select",""],["","49884015676","VARENICLINE","TAB 1MG","56","Select","Select",""],["","59746000103","METHYLPRED","TAB 4MG","21","Select","Select",""],["","00115180301","HYDROXYZ PAM","CAP 25MG","20","Select","Select",""],["","00378668910","PANTOPRAZOLE SODIUM","40 MG","90","Select","Select",""],["","00115521116","COLESTIPOL HCL","1 G","60","Select","Select",""],["","42799080601","IVERMECTIN","3 MG","10","Select","Select",""],["","68462041820","LIDOCAINE","5 %","35.44","Select","Select",""],["","21922002107","PERMETHRIN","5 %","60","Select","Select",""]]}},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Review of Systems and Diagnoses","q":[{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Pain","q":[{"a":[]}]},{"t":"Vital Signs","q":[{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Exam Review","q":[{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Screenings Needed","q":[{"a":{"indx":["","1"],"comment":["",""],"sub":[]}},{"a":{"indx":["","1"],"comment":["",""],"sub":[]}},{"a":{"indx":["","1"],"comment":["",""],"sub":[]}},{"a":{"indx":["","1"],"comment":["",""],"sub":[]}},{"a":{"indx":["","1"],"comment":["",""],"sub":[]}},{"a":{"indx":["","1"],"comment":["",""],"sub":[]}},{"a":{"indx":["","1"],"comment":["",""],"sub":[]}},{"a":[]}]},{"t":"Mini-Cog","q":[{"a":[]},{"a":[]}]},{"t":"Home Safety & Personal Goals","q":[{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Active Problem Conditions","q":[{"a":[]}]},{"t":"Patient Summary","q":[{"a1":"","a2":"","a3":"","a4":"","a5":"","a6":"","a7":[],"a8":"","a9":"","a10":[],"a11":"","a12":"","a13":""}]}]}